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Younger women who take oestrogens to relieve menopausal symptoms can be reassured that the treatment won't increase their risk of heart disease, say researchers. In a large randomised study women aged between 50 and 59 who took oestrogen only hormone replacement therapy after a hysterectomy developed significantly less coronary artery calcification than similar women given a placebo. Both groups took their pills for a mean of 7.4 years.

Coronary artery calcification is a good marker for atherosclerosis and correlates well with the risk of coronary heart disease, says a linked editorial (pp 2639-41). The protective effects of oestrogens in younger menopausal women are consistent with much of the randomised and observational evidence so far, and indicate that such women with bad symptoms can probably stop worrying about the short term cardiovascular effects of hormone replacement therapy.

The new study was a spin-off from the Women's Health Initiative oestrogen only trial. Researchers used computed tomography of the heart to examine 1064 of the younger women participants. Treatment with oestrogen reduced coronary artery calcification by at least 42% (P=0.03).

These findings may be reassuring, but they don't necessarily indicate that oestrogens prevent heart disease, says the editorial. Doctors shouldn't be tempted to prescribe them for that purpose.

References

N Engl J Med 2007;356:2591-602

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